Anne McLeodSenior Vice President, Health Policy & Innovation

July 15, 2011

Anne McLeod provides leadership for developing policy objectives that support the growth and success of hospitals and health systems as they respond to challenges they face.

Anne joined CHA in 2007 and immediately began working on health policy and financing issues with then Gov. Schwarzenegger’s health care reform team. Anne designed and developed the original hospital fee, a landmark program for the hospital industry, providing billions of dollars of new funding.

She managed the efforts of CHA’s Transforming for Tomorrow Task Force, which developed forward-thinking strategies and actions for hospitals to consider as they plan for the future. Most recently she spearheaded the only population health management certification program for leaders in California’s hospitals to help reform and transform health care.

Before joining CHA, Anne served as a financial executive at several of California’s hospitals and health systems, and in California’s banking industry. Anne earned an undergraduate degree in finance, a post-graduate degree from the prestigious Pacific Coast Banking School at the University of Washington’s Graduate School of Business, and a master’s degree in public health policy and management from the University of North Carolina at Chapel Hill.

A three-judge panel of the U.S. Ninth Circuit Court of Appeals Monday released its decision that a 10 percent Medi-Cal outpatient fee-for-service rate cut, imposed by California from July 2008 through February 2009, was illegal because the state did not demonstrate that Medi-Cal patients’ access to services was equivalent to that of other patients. The 10 percent cut was replaced by a 1 percent cut in March 2009; in April of that year the Hospital Fee Program took effect, allowing hospitals to obtain reimbursement rates at or near the federal maximum.

CHA challenged the rate cut in 2008, and ultimately settled it as part of an overarching settlement involving other rate cases. However, a group of hospitals represented by a different law firm had separate litigation filed challenging the hospital outpatient rates, and continued with their case; these hospitals were deemed to have opted out of the CHA settlement. The case was sent back to the district court for further proceedings consistent with the Ninth Circuit’s opinion, which could range from issuing an order enjoining the state from implementing the rate cut to giving the government another opportunity to show that equal access existed. Regardless of the ultimate outcome, the decision is helpful to providers as it requires the state Medicaid agency to demonstrate equivalent access to care between Medi-Cal and other patients.

Attorney General Xavier Becerra announced today California’s intervention in a lawsuit, The United States House of Representatives v. Thomas E. Price, M.D. Secretary of Health and Human Services; U.S. Department of Health and Human Services; and, Steven T. Mnuchin, Secretary of the Treasury; U.S. Department of the Treasury (House v. Price). The case challenges whether an appropriation is necessary to fund the Affordable Care Act’s (ACA) cost-sharing reductions (CSRs). California is one of many intervening states; others include New York, Connecticut, Delaware, Hawaii, Iowa, Illinois, Kentucky, Oregon, New Mexico, Maryland, Massachusetts, Minnesota, Pennsylvania, Washington and the District of Columbia.

In support of the state’s motion to intervene, Anne McLeod, senior vice president, health policy and innovation, prepared a declaration on behalf of CHA. Part of the declaration states, “When individuals and families don’t have health care coverage, they also lose access to care. Providers don’t get paid to treat uninsured individuals. When patients can’t be seen by a primary care doctor, they often turn to hospital emergency rooms as a last resort. More uninsured individuals will seek care in hospital emergency rooms – the most expensive place to be treated – if funding for CSRs is lost.”

Yesterday, CHA met with representatives from the Centers for Medicare & Medicaid Services (CMS) at its headquarters in Baltimore to discuss the Medicaid managed care rules finalized in May 2016 and January 2017 and, specifically, their impact on the Quality Assurance Fee (QAF) program.

The state Legislature held a joint informational hearing of the health committees of both houses yesterday to discuss implementation of the Medicaid managed care rule. The new federal rule will impact plans, providers and consumers. CHA participated on the provider panel to address concerns about the impact to the hospital fee program, which could result in potentially fewer resources for hospitals and Medi-Cal patients. Anne McLeod, senior vice president for health policy and innovation, represented CHA.

“The current method of making supplemental payments through Medi-Cal managed care plans is not aligned with the requirements in the final rules. They are considered pass-through payments and must be phased out starting July 1, 2017,” said McLeod. “The hospital fee could be much smaller than any of us want it to be — billions of dollars less. This means less money for hospital care for Medi-Cal beneficiaries, and it means that for every dollar we have to shrink the program, the state loses 24 cents.”

The committees also heard remarks from the Department of Health Care Services, Medi-Cal managed care plans, consumers and other stakeholders. The meeting agenda is attached.

In opposition to AB 975 (Wieckowski/Bonta), CHA has embarked on a comprehensive public advocacy campaign to increase awareness of the importance of not-for-profit hospitals and the diverse array of community benefit programs they provide throughout California. A new video (below) describes the vital role nonprofit hospitals play in the communities they serve.

California’s health care system performs well across many areas, including care management, overall costs and cost trends. Our state’s consistently lower levels of utilization have been a major driver of lower per capita health care costs. For every major measure of hospital utilization, care provided in California’s hospitals ranks among the most efficient in the nation.

California’s health care system performs well across many areas, including care management, overall costs and cost trends. Our state’s consistently lower levels of utilization have been a major driver of lower per capita health care costs. For every major measure of hospital utilization, care provided in California’s hospitals ranks among the most efficient in the nation. As a result, California’s average per capita spending is well below the national average, despite a significantly higher cost of doing business in the state.

CHA issued individual working models this week — using CHA DataSuite — to assist hospitals in estimating the amount of incentive payments that would be available through the American Recovery and Reinvestment Act (ARRA) of 2009.

As a result of three key actions, the Managed Risk Medical Insurance Board (MRMIB) has determined that funding for the Healthy Families (HF) program is now sufficient to avoid disenrolling children as previously planned (see Aug. 28 CHA News). The final fiscal year 2009-10 state budget had reduced funding for the HF program by more than $170 million.